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Background While studies of ex-orphanage care show adverse effects on development, the longer-term impact on mid-life psychosocial functioning and physical health has not been established. Methods Orphanage records provided baseline data on a sample of 100 Hong Kong Chinese girls who were subsequently adopted into the UK. A mid-life follow-up using standardised questionnaires and face-to-face interviews assessed current circumstances, life satisfaction and mental and physical health outcomes. Comparisons were made with age-matched UK-born adopted and nonadopted women. Results Half the group spent between 1 and 2 years in orphanages, average age at adoptive placement was 23 months and 72% participated in the follow-up. Despite this poor early start, mid-life outcomes were commensurate with the comparison groups in terms of mental and physical health measures. Serious psychiatric and social difficulties were largely absent. Although the timing and extent of exposure to orphanage care did not influence outcome, participants' reports of poorer quality adoptive family experience and a negative view of their adoption were significantly associated with poorer mental health outcomes (difference in means = 0.76, 95% CI 1.33-0.19, p = .01; difference in means = 1.2, 95% CI 0.68-1.73, p = .01, respectively). Conclusions Moderately depriving orphanage care did not predict enduring adverse consequences in mid-life but subsequent poor adoption experience was associated with outcome. [ABSTRACT FROM AUTHOR]

Follow-up studies of adopted adults are very important in contributing to the development of policy and practice when placing children in families following early adversity. This article describes the development of a methodology for one such study due to be completed in 2012. The files of 100 ethnic Chinese girls adopted from Hong Kong into British families in the 1960s were made available and originally analysed in 2007. As the files recorded data on the children's pre-adoption experiences including orphanage care, this provided an opportunity to explore a well-established hypothesis that early orphanage experience has an enduring effect on later outcomes. However, given this group of women are now in their 40s and 50s, identifying these outcomes may offer a much longer term perspective to that usually available in research studies of this kind. This article reports the findings from an analysis of the information held on these files. It then discusses the benefits and challenges of developing a robust methodology for a follow-up study that compares this group of women with other adopted and non-adopted groups of a similar age and in particular explores how post-adoption experiences across the lifespan might moderate the effects of early adversity. Following up this group of women into their middle years and using data available about their early experiences provides a unique opportunity to test and challenge existing theories about the long-term consequences of international adoption. This will help to inform both policy and direct social work practice when children are being considered and placed through international adoption today. [ABSTRACT FROM AUTHOR]

In the field of international adoption there has been a long-standing concern that transracially adopted people experience social dislocation from both their communities of origin and the communities in which they grew up. Alan Rushton, Margaret Grant, John Simmonds and Julia Feast of the British Chinese Adoption Study team explore this notion in relation to a sample of 72 ex-orphanage, Hong Kong-born women adopted into British families in the 1960s. The authors report on how the women choose to identify themselves in mid life. The article describes the development and use of specially devised questionnaires to explore community connectedness and self-regard among this group of women. Further analysis examines the relationship between community connectedness and psychological well-being. The findings are then positioned in the context of the narrative data from face-to-face interviews with the women. [ABSTRACT FROM AUTHOR]